. 2023 Mar;38(3):859-866.

doi: 10.1007/s00467-022-05679-y. Epub 2022 Jul 14.

Immunologic response to SARS-CoV-2 mRNA vaccination in pediatric kidney transplant recipients

Rachael F Kermond¹, Justyna E Ozimek-Kulik^{2

3}, Siah Kim^{4

5

6}, Stephen I Alexander^{4

5

7}, Deirdre Hahn⁴, Alison Kesson^{7

8

9}, Nicholas Wood^{7

10

11}, Hugh J McCarthy^{4

12

5}, Anne M Durkan^{4

7}

Affiliations

¹ Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia. rachael.kermond@health.nsw.gov.au.
² Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia. justyna.ozimek-kulik@monashhealth.org.
³ School of Women's and Children's Health, University of New South Wales, Kensington, Australia. justyna.ozimek-kulik@monashhealth.org.
⁴ Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
⁵ Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia.
⁶ School of Public Health, Sydney University, Camperdown, NSW, Australia.
⁷ School of Pediatrics and Child Health, University of Sydney, Sydney, Australia.
⁸ Department of Infectious Disease, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
⁹ Sydney Institute for Infectious Diseases, University of Sydney, Sydney, Australia.
¹⁰ Department of General Pediatrics, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
¹¹ National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals Network, Sydney, Australia.
¹² School of Women's and Children's Health, University of New South Wales, Kensington, Australia.

PMID: 35833990
PMCID: PMC9281214
DOI: 10.1007/s00467-022-05679-y

Immunologic response to SARS-CoV-2 mRNA vaccination in pediatric kidney transplant recipients

Rachael F Kermond et al. Pediatr Nephrol. 2023 Mar.

. 2023 Mar;38(3):859-866.

doi: 10.1007/s00467-022-05679-y. Epub 2022 Jul 14.

Authors

Affiliations

¹ Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia. rachael.kermond@health.nsw.gov.au.
² Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia. justyna.ozimek-kulik@monashhealth.org.
³ School of Women's and Children's Health, University of New South Wales, Kensington, Australia. justyna.ozimek-kulik@monashhealth.org.
⁴ Department of Pediatric Nephrology, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
⁵ Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia.
⁶ School of Public Health, Sydney University, Camperdown, NSW, Australia.
⁷ School of Pediatrics and Child Health, University of Sydney, Sydney, Australia.
⁸ Department of Infectious Disease, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
⁹ Sydney Institute for Infectious Diseases, University of Sydney, Sydney, Australia.
¹⁰ Department of General Pediatrics, Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
¹¹ National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals Network, Sydney, Australia.
¹² School of Women's and Children's Health, University of New South Wales, Kensington, Australia.

PMID: 35833990
PMCID: PMC9281214
DOI: 10.1007/s00467-022-05679-y

Abstract

Background: COVID-19 disease in kidney transplant (KT) recipients is associated with increased morbidity, mortality, and hospitalization rates. Unfortunately, KT recipients also have a reduced response to SARS-CoV-2 immunization. The primary aim of this study was to assess immunologic response to SARS-CoV-2 mRNA vaccines in pediatric kidney transplant recipients 12-18 years of age. Secondary aims were to assess response rates following a third immunization and determine factors that influence immunization response.

Methods: Pediatric KT recipients in a single tertiary center received SARS-CoV-2 mRNA vaccination as per local protocol. SARS-CoV-2 immunoglobulin (IgG) was measured following second and/or third vaccination. Demographics including patient factors (age, gender, and underlying disease), transplant factors (time and type of transplant), and immunosuppression (induction, maintenance, and immunomodulatory therapies such as IVIG) were collected from the medical records.

Results: Of 20 participants, 10 (50%) responded following a two-dose vaccine schedule, which increased to 15 (75%) after three doses. Maintenance immunosuppression affected immunologic response, with azathioprine demonstrating a higher rate of response to vaccine compared to mycophenolate (100% vs. 38%, p = 0.04). Increasing prednisolone dose had a negative impact on immunologic response (0.01 mg/kg/day increase: OR 1.60 95% CI 1.01 to 2.57). Tacrolimus dose and trough levels, age, time post-transplant, underlying disease, and other immunosuppression did not impact immunologic response.

Conclusions: Pediatric KT recipients had similar response rates following SARS-CoV-2 immunization as adult KT recipients. Immunologic response improved following a third immunization. Choice of antimetabolite and prednisolone dosing influenced the rate of response. A higher resolution version of the Graphical abstract is available as Supplementary Information.

Keywords: COVID; Immune response; Kidney; Pediatric; Transplantation; Vaccination.

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Conflict of interest statement

The authors declare no competing interests.

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References

1. Cui X, Zhao Z, Zhang T, Guo W, et al. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19) J Med Virol. 2021;93:1057–1069. doi: 10.1002/jmv.26398. - DOI - PMC - PubMed
1. Cheung EW, Zachariah P, Gorelik M, Boneparth A, et al. Multisystem inflammatory syndrome related to COVID-19 in previously healthy children and adolescents in New York City. JAMA. 2020;324:294–296. doi: 10.1001/jama.2020.10374. - DOI - PMC - PubMed
1. Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, et al. Long COVID in children and adolescents. World J Pediatr. 2021;17:495–499. doi: 10.1007/s12519-021-00457-6. - DOI - PMC - PubMed
1. Buonsenso D, Munblit D, De Rose C, Sinatti D, et al. Preliminary evidence on long COVID in children. Acta Paediatr. 2021;110:2208–2211. doi: 10.1111/apa.15870. - DOI - PMC - PubMed
1. Hilbrands LB, Duivenvoorden R, Vart P, Franssen CFM, et al. COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration. Nephrol Dial Transplant. 2020;35:1973–1983. doi: 10.1093/ndt/gfaa261. - DOI - PMC - PubMed

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Immunologic response to SARS-CoV-2 mRNA vaccination in pediatric kidney transplant recipients

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Immunologic response to SARS-CoV-2 mRNA vaccination in pediatric kidney transplant recipients

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